title: Adverse effects of psychosocial work factors on blood pressure: systematic review of studies on demand-control-support and effort-reward imbalance models.
abstract: OBJECTIVE
  A growing body of research has investigated the adverse effects of psychosocial work factors on blood pressure (BP) elevation. There is now a clear need for an up-to-date, critical synthesis of reliable findings on this topic. This systematic review aimed to evaluate the adverse effects of psychosocial work factors of both the demand-control-support (DCS) and effort-reward imbalance (ERI) models on BP among men and women, according to the methodological quality of the studies.
  
  
  METHODS
  To be eligible, studies had to: (i) evaluate at least one psychosocial work factor, (ii) evaluate BP or hypertension, (iii) comprise ≥100 workers, (iv) be written in English or French, and (v) be published in a peer-reviewed journal.
  
  
  RESULTS
  A total of 74 studies were included. Of these, 64 examined the DCS model, and 12 looked at the ERI model, with 2 studies considering both models. Approximately half the studies observed a significant adverse effect of psychosocial work factors on BP. A more consistent effect was observed, however, among men than women. For job strain, a more consistent effect was also observed in studies of higher methodological quality, ie, studies using a prospective design and ambulatory BP measures.
  
  
  CONCLUSIONS
  A more consistent adverse effect of psychosocial work factors was observed among men than women and in studies of higher methodological quality. These findings contribute to the current effort of primary prevention of cardiovascular disease by documenting the psychosocial etiology of elevated BP, a major cardiovascular risk factor.
authors.affiliation: Population health research unit, St-Sacrement hospital, 1050, Chemin Ste-Foy, Quebec City, Quebec, Canada G1S 4L8. mahee.g.ouimet@gmail.com.
authors.forename: Mahée
authors.initials: M
authors.lastname: Gilbert-Ouimet
authors.forename: Xavier
authors.initials: X
authors.lastname: Trudel
authors.forename: Chantal
authors.initials: C
authors.lastname: Brisson
authors.forename: Alain
authors.initials: A
authors.lastname: Milot
authors.forename: Michel
authors.initials: M
authors.lastname: Vézina
mesh_terms: D000328:Adult; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D015984:Causality; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D011446:Prospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D012949:Social Work, Psychiatric; D013315:Stress, Psychological / Q000453:epidemiology*; D016526:Workload / Q000523:psychology*